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Medication Management


A national medication management stakeholder community sharing knowledge, information and resources to promote medication safety practices.
Members: 359
Contact: Seema Nayani
Admins: Linda Monico
Type: Open
Access: Public
A national medication management stakeholder community sharing knowledge, information and resources to promote medication safety practices.

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Scientific Notation to be introduced into CCDD for the May 2021 release 04/27/21

Please be advised that beginning with the May 2021 CCDD release, any strength value ≥1x109 will be expressed using scientific notation in the following format, 1e9. This change will affect two published concepts, one NTP and one MP each, which will b...

COVID-19 vaccines to be added to CCDD starting January 2021 12/22/20

This is to advise you that COVID-19 vaccine concepts will be included in CCDD beginning with the January update. In order to provide this content in a timely fashion, COVID-19 vaccine content will be added to the existing CCDD files (TM, NTP, MP and...

Health Canada Code Systems - cross posted 11/17/20

I have updated the OID descriptions as noted below. Marc's corrections for AIGc and AIGn have been included however, for consistency with the UTG project, the descriptions for hcAIC was updated to the description that Health Canada provided. Al...

CCDD Immunization Discussion Nov 3, noon ET 11/12/20

Hello On behalf of Health Canada's Health Products and Food Branch (CCDD Unit) I would like to thankyou to those who joined the call. please find the meeting notes here ... Regards Beverly

Health Canada Code Systems - cross posted 11/06/20

*Note: Contains "boardcode", recommend viewing on forum. Plain text email will not show corrections properly. I have some concerns: 1. AIC: The updated description referring to foreign keys of various tables is inappropriate. The current des...

Health Canada Code Systems - cross posted 11/06/20

We met with Daniel Buijs from Health Canada yesterday to review all of the Health Canada Code Systems - (CCDD, DIN, NPN, AIGn, AIGc, AIC). In the course of that conversation, we received updated information for the Code Systems - mainly updated email...

CCDD Immunization Discussion Nov 3, noon ET 10/26/20

Here is the link to the presentation that will be used for the discussion; ... Here is the link to the CCDD Immunization file format (that will be incorporated within the CCDD Technical Specification; ... Here are the links to the CCDD Immuniza...

Access to CCDD files on Terminology Gateway 10/22/20

Hello Currently every CCDD release has been available for download from the Terminology Gateway (since 2017). The plan going forward is to provide up to one year of past CCDD release versions active within the Terminology Gateway. If anyone has a...

CCDD Immunization Discussion Nov 3, noon ET 10/20/20

Hello Please join us for a follow up discussion from the last call in June to discuss how immunization content will be added to CCDD. the powerpoint for this call will be posted shortly When: Nov 3, 2020 12:00 PM Eastern Time (US and Canada)...

CCDD Immunization discussion June 25th at noon ET 06/30/20

Thankyou to those who attended this meeting. To summarize the call the following was discussed: 1 Use cases and scope - no concerns expressed 2 Encoding options for the immunization content within CCDD - a comment was rec'd that if SNOMED was...

CCDD Immunization discussion June 25th at noon ET 06/19/20

Hello please join us to discuss plans to add immunization content to CCDD. A call will be held on June 25th at noon ET to introduce you to the approach. the discussion document can be found here ... Examples referenced in the discussion p...

May 2020, CCDD Release Update 05/22/20

Due to competing priorities at Health Canada with the impact of COVID we are unable to publish a May CCDD release. Our sincere apologies. If you have any questions, please reach out to clinicaldrug@infoway-inforoute.ca Regards Beverly & the CCDD...

Medications and Immunizations Draft Profiles are Complete and Ready for Review 04/22/20

Dear members of the Medication Management group, All the Canadian Core Medications and Immunizations draft profiles are complete. Please review these draft profiles at https://build.fhir.org/ig/scratch-fhir-profiles/CA-Core/artifacts.html and prov...

CCDD operations during COVID-19 03/26/20

The Canadian Clinical Drug Dataset (CCDD) Business Operations during COVID-19 Health Canada’s Health Products and Food Branch and Canada Health Infoway are continuing to monitor the COVID-19 response closely and plan to ensure the CCDD continues t...

Device NTP content within CCDD 02/11/20

Hi As a result of the discussion to add Valved holding chamber devices to the CCDD at the Jan 23rd call and further review of the required content, we are proposing the following: 1 - Device manufactured product concepts will not be added to CCDD i...

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Documents

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Note: Group members are not currently notified when new documents are added. To notify others, you must post the URL to the new document in the forum. (Notification of document uploads is a feature in development.)

Video

5 Questions to Ask About Your Medications

Empower your patients to ask questions to keep them safe from medication harm. Presented by ISMP Canada

12/19/16

Solutions

  • Canadian FHIR Registry
  • Canadian URI Registry
  • FHIR Terminology Service API
  • FHIR Uniform Resource Identifier (URI)
  • HAPI FHIR
  • HAPI v2
  • HL7 Explorer
  • InfoRMS
  • Message Builder
  • Message ReMixer
  • Object Identifier (OID)
  • SNOMED CT Browser
  • Terminology Gateway
  • Terminology Service API
  • TermManager
  • TermWorks
  • Webhook Notifications

The Canadian FHIR® Registry supports collaborative development in an effort to accelerate sustainable growth of FHIR, locally and internationally. The registry is the home of national FHIR profiles recommended for use in Canada, including extensions, value sets, URIs and other useful, commonly used components. It is also host to a growing number of national, jurisdictional and locally shared FHIR projects, and is open at no cost to all Canadian implementers.

The Canadian FHIR Registry offers:

  • seamless integration of profile editing using Forge (free FHIR profile editor)
  • designated project space
  • supports project teams of up to 100 individuals
  • online authoring of implementation guides
  • integration with source control tools such as GitHub
  • version controlled environment

The Canadian FHIR Registry blends software development best practices with the requirements of modelling in FHIR, essential to delivering successful project requirements while having continuous access to structure validation, rendering and publishing.

Organization projects can be viewed without logging in. To edit or request a new project, This email address is being protected from spambots. You need JavaScript enabled to view it. with the details.

View projects in the Canadian FHIR Registry

Service Level Agreement and Business Continuity

Simplifier.net should not be used in a production setting, as 24/7 support is not provided by Infoway or Firely®.

A project created in the Canadian FHIR Registry can be linked to an existing GitHub account. GitHub serves as a secondary backup and can sync the content in the project accordingly. Read details on how to set this up

Users of the Canadian FHIR Registry on the Simplifier platform can expect the following response time from the Firely team for any issue encountered.

Issue Premium Support Description
High Priority
  • Response time < 4 hours
  • Resolution time < 8 hours
Work halts and affects a large number of users
Medium Priority
  • Response time < 4 hours
  • Resolution time < 16 hours
Able to continue working but affects a small number of users
Low Priority
  • Response time < 4 hours
  • Resolution time < 24 hours
Able to continue work and affects a couple of users
Tickets
  • Unlimited
Able to influence the product’s road map

Read an overview of the Service Level Agreement between Infoway and Simplifier.net.

All project artifacts are backed up weekly at midnight on Sundays. Each snapshot will be retained for 10 days. The project owner can request an as-is snapshot containing all the necessary artifacts such as text, xml, json, md and image files by contacting This email address is being protected from spambots. You need JavaScript enabled to view it..

Forge License Agreement

As per the statement issued on the Firely blog,  Securing the future of Forge, the free version of Forge will be licensed for non-commercial use only starting January 1, 2020. To continue using Forge, users will need to be part of a paid plan on Simplifer.net. The current contract between Infoway and Firely for Simplifier.net allows for an unlimited number of users of Forge. Infoway has received confirmation from Firely that this will remain unaffected until December 31, 2021. If the authors in Simplifier.net belong to projects that are part of the Canadian FHIR Registry, they will be given rights through the administration processes of the platform conducted by Infoway.

The Canadian URI Project is a repository of identifier and code system namespaces. Capturing key metadata as FHIR® NamingSystem resources provides an automatic mapping of OIDs to URIs or vice versa.

To make the discovery of these artifacts more flexible, the Canadian URI Registry (alpha) was developed to allow artifacts to be queried via plain text, OID, URI or their respective identifiers. These identifiers are created according to the URI guidelines and posted to the FHIR Solution Architecture Workstream for approval.

It is important to note that all searchable artifacts are to be curated via the Canadian URI Project in Simplifier. There are ongoing discussions with the FHIR Solution Architecture Stream to have a single representative manage data for their respective jurisdictions.

A scheduled task is run periodically, making all new or modified artifacts searchable after a 20 minute window.

Search the Canadian URI Registry (alpha)

FHIR web services used to access terminology data

FHIR Terminology Service APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertize in the fine details of terminology.

terminology gateway APIFHIR Terminology Service API

 

A Uniform Resource Identifier (URI) is a globally unique string of characters that provides a simple and extensible means for identifying a resource. URIs are used to identify a namespace or the location of a resource. URIs are human-readable and offer the potential for resolvability. The HL7 FHIR® specification recommends using URIs to have all resources resolvable and to comply with the FHIR RESTful paradigm.

URI Registration Process

  1. Requestor shall first check that the URI does not already exist in the Canadian URI Project, Jurisdictional Registry (if exists) or HL7 FHIR Specification
  2. FHIR URIs must not be proposed for Subsets to be published on the Terminology Gateway as they will be generated automatically.
  3. Requestor shall contact the owner or respresentative for either:
  4. Forum posts shall have the following format:

    Subject: New URI Request
    • Description: “A description of the URI”
    • Responsible Body & Contact Information
    • Proposed FHIR URI: URI as per URI Guidelines
    • Existing OID (if exists)
    • To be published (optional): Jurisidictional repository/ Canadian URI Registry
  5. There will be a wait period of five business days for the communities to react to the forum post with comments, questions or requests for clarification.
  6. Update Forum post will be updated with the new URI.
  7. Publishing the URI in the Canadian URI Registry and Jurisdictional Registry. This is highly recommended to prevent any misuse or duplication of URIs but it is optional.

See a flowchart of the FHIR URI Registration Process (pdf).

Open source integration tools useful for health IT integration projects

HAPI FHIR® is a simple-but-powerful library for adding FHIR messaging to applications. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.

HAPI FHIR

 

External Solutions for API integration

Open source integration tools useful for health IT integration projects.

 
HAPI v2
 

HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform

 
HAPI FHIR
 

HAPI FHIR is a simple-but-powerful library for adding FHIR messaging to your application. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.

Open source integration tool useful for health IT integration projects

HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform.

HAPI v2

  HL7 Explorer retired November 29, 2019

HL7 Explorer retired on November 29, 2019 with no further updates or maintenance. Access will continue “as is”.

NOTE: HL7 Explorer is not currently available due to a technical issue.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions or concerns.

Enhanced browsing of HL7 v3

Infoway HL7 Explorer is a powerful browser for HL7 v3 structures, vocabulary and references. Used in conjunction with the pan-Canadian releases, HL7 Explorer makes locating details and information more efficient.

In November 2017, the Canadian HL7 InfoCentral community determined that there was no longer any need to do further updates to the pan-Canadian Version 3 messages. As a result, the December 2012 releases of MR02.06.01 and CeRx 4.4.2 are the latest pan-Canadian publications of these standardized messages.

The HL7 Explorer, the Master Terminology Worksheet (MTW) and all other messaging related artifacts are aligned with the latest releases.

Overview
 

Learn about the features HL7 Explorer: search once, graphical representation, quick hints, etc.

MR 02.06
 

HL7 Explorer applied to the MR 02.06 HL7 v3 maintenance release

CeRx 4.4.2
 

HL7 Explorer applied to the CeRx 4.4.2 HL7 v3 maintenance release

 

 

Standards versions available for viewing in HL7 Explorer

StandardURL 
CA MR 02.06 https://sl.infoway-inforoute.ca/extra/ca/mr0206-html/html/search.html
CA MR 02.05.01 https://sl.infoway-inforoute.ca/extra/ca/mr020501-html/html/start.html
CA MR 02.05 https://sl.infoway-inforoute.ca/extra/ca/mr0205-html/html/start.html
CA MR 02.04.03 https://sl.infoway-inforoute.ca/extra/ca/mr020403-html/html/start.html
CA CeRx 4.4.2 https://sl.infoway-inforoute.ca/extra/ca/cerx442-html/html/search.html
CA CeRx 4.4.1 https://sl.infoway-inforoute.ca/extra/ca/cerx441-html/html/start.html 
CA CeRx 4.4 https://sl.infoway-inforoute.ca/extra/ca/cerx44-html/html/start.html
BC V02R04 https://sl.infoway-inforoute.ca/extra/bc/v02r04-html/html/start.html
NS CeRx 4.3 https://sl.infoway-inforoute.ca/extra/ns/cerx43-html/html/start.html
NS R02.04.03 https://sl.infoway-inforoute.ca/extra/ns/r020403-html/html/start.html
AB MR2007 https://sl.infoway-inforoute.ca/extra/ab/mr2007-html/html/start.html
AB R02.04.03 https://sl.infoway-inforoute.ca/extra/ab/r020403-html/html/start.html
AB R02.04.00 SHR https://sl.infoway-inforoute.ca/extra/ab/r020400-shr-html/html/start.html
AB R02.04.03 Imm https://sl.infoway-inforoute.ca/extra/ab/r020403-imm-html/html/start.html

Request Management Solution

Infoway Request Management System (InfoRMS) is Infoway's Request for Change (RFC) tool for SNOMED CT, pCLOCD/LOINC® and pan-Canadian Subsets. Not sure if you have access to InfoRMS? Manage your InfoRMS Access in your user profile.

 

snomed ct SNOMED CT

In order to ensure that SNOMED CT RFCs are addressed in an efficient and timely manner, it is the requestor's responsibility to:

  1. Ensure that the content does not exist in either the International or Canadian editions of SNOMED CT;
  2. Ensure that the request conforms with the most recent Editorial Guidelines;
  3. Provide the date of implementation;
  4. Provide reference material that is publicly available, authoritative, recent and relevant to the request (Wikipedia is not considered appropriate);
  5. Support the request with a clear justification for the change and an appropriate use case for context;
  6. Ensure all mandatory InfoRMS fields have been completed prior to submission.

Login to submit or follow requests to SNOMED CT 

 

pCLOCD leaf symbol pCLOCD/LOINC

Prior to submitting a pCLOCD/LOINC request, it is the requestor's responsibility to:

  1. Ensure that the content does not exist in LOINC or the pCLOCD;
  2. Ensure that a similar or equivalent term has not already been requested, by way of searching the online LOINC Submissions Queue;
  3. Ensure that a similar or equivalent term has not already been accepted and under development for the next official release, by way of searching LOINC Pre-release terms;
  4. Comply with Regenstrief Editorial Guidelines (note: login required).

Login to submit or follow requests to pCLOCD/LOINC 

 

subsets magnifying glass on monitor Subsets

Prior to submitting a Subset request, it is the requestor's responsibility to:

  1. Validate the content against the subsets in Terminology Gateway;
  2. Comply with the appropriate proper terminology Editorial Guidelines.

Login to submit or follow requests to pan-Canadian Subsets 

  Message Builder retired November 29, 2019

Message Builder retired November 29, 2019 and is no longer supported. The source code and all supporting documentation is available as-is on GitHub:

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions or concerns.

  Message ReMixer retired November 29, 2019

Message ReMixer retired on November 29, 2019 and is no longer accessible.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions or concerns.

Pan-Canadian Standards use Object Identifiers (OIDs) to distinguish between objects by assigning a numeric string that enables other systems to understand the unique information that is being shared between various systems.

Canada Health Infoway (Infoway) has an arrangement in place with HL7 International that allows Infoway to submit OIDs to HL7 International on behalf of Canadian Implementers free of charge. There is a $500 USD fee per OID request if done directly with HL7 International.

To submit an OID, download the registration form that corresponds to your OID request.

  • For Infoway owned subsets, email the completed form to This email address is being protected from spambots. You need JavaScript enabled to view it.
  • For all non-jurisdictional requests, please follow the instructions below
  • All other requests must be sent to the Jurisdictional Representatives for OIDs

OID submission guidelines

  1. Jurisdictional Teams require 5-7 business days to process each request. It will be incumbent on the requestor to reply within this time frame to any questions and follow up as required. Any failure to do so will result in an automatic rejection and require resubmitting the request.
  2. The Requestor must post the OID requests on the following forums ONLY after consulting with the Jurisdiction/Infoway SME:
  3. Forum posts shall have the following format:

    Subject: New Namespace/CodeSystem/Subset OID Request
    • OID Description: “A description of the OID”
    • OID Symbolic name: Symbolic name guidelines
    • Responsible Body & Contact Information
    • Proposed FHIR URI: URI as per URI Guidelines
    • To be published: Canadian URI Registry/Terminology Gateway

  4. There will be a wait period of 5 business days for the communities to react to the forum post with comments, questions or requests for clarification.
  5. FHIR URIs must be proposed for all jurisdictional and non-jurisdictional OID requests according to the URI Guidelines and must be published in the Canadian URI Registry. Publishing the URI is an optional but highly recommended step. The Requestor will submit a validated FHIR® NamingSystem resource object based on the NamingSystem profile to their jurisdictional representative who will then upload it.
  6. FHIR URIs must not be proposed for Subsets to be published on the Terminology Gateway as they will be generated automatically.
  7. The Forum post will be updated with the new OID.

Browse International and Canadian Content

SNOMED International's SNOMED CT browser allows users to search for existing concepts and explore relationships. It also provides access to browse national extensions from SNOMED International member countries including the Canadian Edition of SNOMED CT in English and French.

snomed browser Browse SNOMED CT Now

 General Documentation

Browse, download and leverage the terminology used in Canada

Terminology Gateway is a web based solution framework that enables the distribution and sharing of terminology concepts, subsets and concept maps, making them available for web browsing, download or real time query.

terminology gatewayBrowse Terminology Gateway Now

RESTful web services used to browse terminology data

Terminology Service RESTful APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertise in the details of terminology.

terminology gateway APITerminology Service API

 

Apelon’s TermManager is a web-based data mapping solution which is provided by request for free to individuals who have Standards Access. It provides comprehensive mapping capability to SNOMED CT and the Canadian Edition of SNOMED CT with multi-user work flow options and flexible output formats.

 Implementation Guidelines & Resources

  • This email address is being protected from spambots. You need JavaScript enabled to view it. - Email your request to This email address is being protected from spambots. You need JavaScript enabled to view it. with the following information:
    • Your InfoCentral username.
    • Is this a new request or are you renewing your access to use TermManager?
    • Intended Use: Please describe the project and mapping requirements. Please Note: TermManager is limited to mapping with SNOMED CT. As more terminologies are available, they will be added.
    • Local Terms: Please describe the source of your local terms (EMR, LIS, etc.).
    • Please describe your requirements/project if they don't fit the above.
  • TermManager Release Notes

knowing Learn More

  • This email address is being protected from spambots. You need JavaScript enabled to view it.
  • Apelon Mapping Tool Presentation
  • SNOMED CT Education
  • TermManager User Guide
  • How TermManager Works
  • TermManager FAQs

Apelon’s TermWorks is an easy-to-use data mapping solution that is provided by request (free of charge) to individuals who have Standards Access. It brings powerful terminology capabilities directly to the desktop. TermWorks combines Microsoft® Excel® spreadsheet software with web services-based terminology processing to give organizations comprehensive mapping capability to SNOMED CT and the Canadian Edition of SNOMED CT.

 

knowing Learn More

  • This email address is being protected from spambots. You need JavaScript enabled to view it.
  • SNOMED CT Education
  • Apelon TermWorks User Guide
  • Infoway User Installation Guide
  • How does TermWorks Work?
  • TermWorks FAQs

Automated notifications of new content in Terminology Gateway

A webhook is an HTTP callback. When new content is published in the Terminology Gateway, a publishing event will be POSTed to each registered webhook, notifying their respective owners about the publication.

Webhook registration

Individual users can register for webhook notifications by sending an email to: This email address is being protected from spambots. You need JavaScript enabled to view it. and specifying the webhook endpoint. Upon registration, a unique api_id will be assigned to the webhook. Each notification POSTed by the Terminology Gateway will contain the api_id, allowing the endpoint to verify that the notification was indeed issued by the Terminology Gateway. The api_id must be echoed back by the webhook endpoint in the body of the notification response.

Webhook interface

The webhook endpoint must serve HTTP requests conforming to the following interface:

HTTP Request

{
  "api_id": "cb570e5a2748f349f9119431db836b3a23fdb6571afee34c0432d87220f2431b",
  "base_url": "https://termapi.infoway-inforoute.ca/rest/v1/",
  "notification_time": "2017110711:07:00",
  "targets": [
    {
      "id": "2.16.840.1.113883.2.20.6.1",
      "name": "Canadian Clinical Drug Data Set (CCDD)",
      "type": "package",
      "version": "20171016",
      "effective_date": "20171016",
      "publication_time": "2017103015:20:23",
      "message": "Monthly CCDD update for October 2017"
    },
    {
      "id": "2.16.840.1.113883.2.20.3.443",
      "name": "PrescribeIT",
      "type": "package",
      "version": "LPR2",
      "effective_date": "20171103",
      "publication_time": "2017110309:37:22",
      "message": "PrescriptionMedicinalCode version reflecting the October 2017 CCDD update"
    }
  ]
}
				
  • api_id: as previously mentioned, each notification POST contains the api_id granted at registration.
  • base_url: the base URL for the native REST API endpoint of the originating system. This can be used to call back the Terminology Gateway via APIs in order to programmatically download updated content.
  • notification_time: the timestamp of the webhook notification in yyyyMMddHH:mm:ss format.
  • targets: list of updated targets. Each entry in this array corresponds to a Terminology Gateway artifact (subset, codesystem, map, package) that was updated and is therefore subject to the notification. The target list will only include artifacts for which the user has registered to receive notifications. Users can register to receive notifications about content updates using the Terminology Gateway User Interface or by invoking the native REST APIs.

    Each of the notification targets contains the following fields:
    • id: the artifact id, typically an OID
    • name: the artifact name
    • type: the artifact type: subset, codesystem, package or map
    • version: the published version id
    • effective_date: the effective date associated to the artifact version, in yyyyMMdd format
    • publication_time: the publication time in yyyyMMddHH:mm:ss format
    • message: optional message describing the published artifact version

HTTP Request

HTTP Response code: 200 for success, any other response code will be interpreted as an error
Sample HTTP Response Body:

{
  "api_id": "cb570e5a2748f349f9119431db836b3a23fdb6571afee34c0432d87220f2431b",
  "result": "success",
  "message": "Successful processing of the webhook notification"
}
  • api_id: as previously mentioned, each notification response must echo back the api_id granted at registration.
  • result: success if the web hook notification was successful, any other value will be interpreted as an error.
  • message: optional response message.


Error handling

When receiving an error as a result of a webhook notification, the Terminology Gateway will retry the notification four times at 15 minutes intervals. If still unsuccessful after four notification attempts, the system will drop the notification and will notify the user by email that the webhook couldn't be invoked.

Sample code

Demo code for a sample webhook endpoint can be found here: 

https://github.com/CanadaHealthInfoway/tgateway-webhook

Web Conference

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Members

Seema Nayani
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Canada Health Infoway
OFFLINE
Contact
Linda Monico
Picture of Linda Monico
Canada Health Infoway
OFFLINE
Admin
paresh parikh
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n/a
OFFLINE
Member
Audrey Li
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Canada Health Infoway
OFFLINE
Member
Analiza Supan
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Centre for Distance Education
OFFLINE
Member
Tarek Kadoura
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Canada Health Infoway
OFFLINE
Member
Anne Belford
Picture of Anne Belford
TELUS
OFFLINE
Member
Aruna Padmanabhan
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n/a
OFFLINE
Member
Anjana Raghuveer
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Health Canada
OFFLINE
Member
Danielle Osborne
Picture of Danielle Osborne
CDED
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Member
Danny Lavoie
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SNB
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Member
Melanie Spring
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CD-ED
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Member
Samim Hasham
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CMAHA Peel Dufferin
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Member
Antony Robert
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McGill University Health Center
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Member
Hayley Chance
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Centre for Distance Education
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